Tuesday, December 14, 2010

Anna's birth story

Given the nature of this post, reader discretion is advised. Details may be sketchy and/or inaccurate, as I was obviously in the throes of labor - this is how I remember it to the best of my ability.

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Anna was born early on Wednesday morning, December 8th. The weekend before that, I started having regular, timeable contractions about every 10-20 minutes. They lasted about 30 to 45 seconds each, and were not painful at all.

That same Saturday morning, Miriam woke up with a fever. She said her head hurt, and later threw up a couple of times. It never fails that some or all of us get sick just a few days before the arrival of a new baby. Midwives have told me this happens a lot and ensures that everyone's immunities to the current bug making the rounds is high by the time baby comes. So in spite of the contractions, I "knew" the baby's arrival was still days away. Miriam got better within the next day and a half after I started letting her drink as much Reed's Ginger Ale as she wanted. The stuff is a miracle cure - it stops vomiting immediately, and brings down a fever faster than tylenol - no joke! She also got a red rash on her torso a day later, so my guess is that she had some sort of virus.

I had taken on a translating assignment that I was working on that weekend (an article from a medical journal), so getting that done and off my desk before baby came was fine with me, anyway. I did finish it up a couple of days before the deadline, just to be safe.

Contractions continued to be every 10 to12 minutes all Monday, with increasing intensity. In the evening, I ran a couple of errands, and other than having to stop whenever another contraction came and holding on to the cart, it was fine. I found some things I wanted to get the kids as Christmas gifts, but could not buy them because they were with me.

During the night from Monday to Tuesday, contractions kept me awake from 3 until 7 am. My mother-in-law is a flight attendant, but had the week off and was waiting "on call" to fly out in case I went into labor, to be an extra set of hands around the house. Around 4:30 am our time, I texted her that I thought she should come out, even though I was not convinced that this was "the real thing". Sure enough, when morning came, the contractions went away for several hours, during which time I slept in. Thankfully, my MIL still came out, as birth was obviously close.

This was Tuesday. I left grandma at home with the kids while I finished up a few last errands, and went back and bought the gifts for the kids I was unable to get the night before. Then I took a nap in the afternoon. Contractions were still every 10 to 12 minutes at this point, and getting to a point where they were requiring my attention. While I was cooking dinner, Solomon and grandma were sitting at the kitchen counter, playing yahtzee. I closed my eyes during a contractions and just stood there, and Solomon said something like "Oh look, Grandma, mom must be really tired. She is falling asleep standing up." It made me laugh, which hurt because it was right in the middle of a contraction.

We inflated the birth pool before going to bed, with the hose to fill it all hooked up and ready to go in case my labor reached the "point of no return" that night. We went to bed around 11 pm, at which time the contractions were about 5 or 6 minutes apart.

During the night from Tuesday to Wednesday, shortly after midnight, my contractions were so strong that they woke me up. By about 2 am, they were about 3 or 4 minutes apart, and increasingly intense. I woke my husband and asked him to start filling the tub. At 2:34 am, I called my midwife and told her that I wasn't sure whether this was the real thing, but that my contractions were regular every few minutes, and becoming pretty painful. She said she'd come over right away. Both her and her assistant arrived within a half hour.

Other than the contractions, I still had none of the other symptoms of active labor, which is what made me so doubtful (i.e. water breaking, mucous plug, etc.). I asked my midwife to check my dilation when she first arrived, and I was at a 3-4 cm. I got in the tub at this point. I don't think the contractions ever got closer than 3 to 5 minutes apart, and while they were very painful/intense, I have had worse. They were relatively manageable with lots of moaning and some slight pressure on this certain spot on my lower back. Later on, I did start throwing up after contractions, but in between them, I felt pretty good, other than being cold (neither the room nor the water was cold) and tired from the lack of sleep in the previous days. 

I don't remember the exact times that it took me to dilate. I think an hour later (around 4:30 am) I was at 7 cm, and did not progress past that in the next 20 or 30 minutes. At that point, the midwife and her assistant relocated to just outside the room I was laboring in, to give me and my husband some privacy/quiet. By this point, I was starting to feel this urgent need to deliver the baby, while also feeling exhausted and like I was going nowhere. However, I did fall asleep between contractions, while in the tub, with my chin resting on my husband's hand on the edge of the tub. 

I'm guessing that it was about 45 minutes or so later when I suddenly felt wide awake. With the next couple of contractions, I felt "pushy", but did not feel like I was fully dilated for some reason. Pushing felt different than it normally did - like I was pushing against something, and also more painful. I asked my midwife to check me and make sure I was dilated, and other than a cervical lip, she confirmed that I was. 

Still, I could not get comfortable pushing. I decided that maybe I needed to use the bathroom, because even a bladder that is *almost* empty can get in the way of a baby's head coming down. Normally, I would have just gone in the tub at this point (sorry if this is too much information, but this is actually important to the story), but simply could not. So I dragged my wet, shivering self to the bathroom, which was only about 5 ft from where the tub was set up in the guest room. Still not able to pee, and still skeptical that I was fully dilated, my midwife wanted to check me on the bed rather than in the tub, which is easier and more accurate. 

As she did, she still felt that lip of the cervix, and coached me to push with the next contraction while she pushed it to the side. The baby immediately slipped into the birth canal, and was born completely within what I am guessing was less than 60 seconds from when she first checked me. What a relief!

I leaned back against my husband for a minute, who was supporting me from behind. As I usually do, I asked "Is the baby alright?", because I felt too weak to sit up and check for myself. I got no reply, so I asked again, and again got no reply. The baby had not cried at all, but that is pretty typical for our babies, because they are usually born in the water, which is gentler on them. I figured the midwife had not heard me because she was busy with the baby. So I asked my husband, who assured me that everything was fine. I sat up to take the baby (this was less than a minute after she was born, I'm guessing), and the midwife placed her on my chest and told me that the baby was okay, and coming around. I said something to the baby, in response to which she let out a little whimper, and then just breathed (sounding a little wet/raspy). I figured that her breathing had been what the midwife was concerned about, and that maybe she had needed to be suctioned. I checked to see if it was a boy or a girl, and was not surprised to find I had been right with my prediction all along. 

Just a minute or so later, my midwife said that she thought the placenta was ready to be pushed out, which surprised me. But sure enough, she was right, and the placenta came out with one big push. 

At this point, everyone came in to see the baby, John (the birthday boy) got to cut the cord, and we were all just rejoicing in this new little creature. It was shortly after 6 am on Wednesday morning. We spent the day resting. My MIL took the 5 oldest kids out of the house from about 9 am until the early afternoon, during which time my husband, Anna, and I napped, rested, and ate a late lunch. It was a nice first day.

It was not until the next day, when my midwife came for the 1-day visit, that I learned some more details about the birth that I was (thankfully) entirely unaware of at the time. I have debated with myself whether to include them here, but see no reason not to, as they are part of the birth story.

When my midwife checked me on the bed after I got out of the tub to use the bathroom, she was no longer able to feel the baby's pulse on the fontanel. Right before getting out of the tub, the baby's heart rate on the doppler had been normal. At this point, she could also see that the baby's head (right on the cervix) was lavender-gray (as opposed to pink, or maybe blanched). Which is why she held the cervical lip to the side and told me to push the baby down. Immediately after the baby came out, she was followed by huge amounts of blood. The baby's cord was also already flat and had stopped pulsing when she was born. All these symptoms indicate that it is likely my placenta had suddenly and completely detached right before the baby was born - a very rare and dangerous condition. Since the cord and placenta are the baby's lifeline, the baby will die in a matter of minutes (my midwife said a maximum of 6 minutes until complete death) if cut off from the placenta before they are born and can breathe on their own. Serious, irreversible brain damage starts occurring about a minute before that. 

In Anna's case, she came around again very quickly, and she is perfectly fine, leading us to believe that she was probably cut off for no more than a minute or two. Most cases of placental abruption are milder (i.e. partial), and have warning signs like bleeding. In our case, all the bleeding was blocked by the baby's body, hence the gush of blood that followed her. There is no way to predict placental abruption, and for cases such as mine (sudden, complete detachment with no warning signs), there is nothing that can be done. No emergency cesarean could be performed quickly enough to save the baby's life, as there are only a couple of minutes that mean the difference between baby living or dying. Hence, placental abruption is one of the leading causes of stillbirth/neonatal death.

Inevitably, I know that this might make some question the safety of home birth, but as I said, being at the hospital would have done nothing to get the baby out faster. On the contrary, I believe that having my labor "managed" would likely have interfered with my natural instincts, such as realizing that pushing didn't feel quite right (probably due to the placenta starting to detach), and getting out of the tub when I usually deliver all of our kids in the water. Any drugs that I might have received at the hospital (such as pitocin) would have greatly aggravated the condition. It was just a rare fluke, that thankfully ended well because of God's hand of protection. We are very blessed indeed.

Other than being more fatigued than usual because of the blood loss, I feel very well. There was no tearing at all, and the afterpains have been manageable with a hot rice pack and some cramp bark tincture. Nursing is going well. Anna is a very easy baby, and already in a predictable pattern of eating and sleeping. I have held/carried her pretty much non-stop since she was born, not because I have to (although it does help keep her asleep), but because I don't want to set her down and miss even one second with her. She has been peacefully asleep on my chest the whole time I spent writing this post.

My husband has been such a huge help with the kids, around the house, and running any necessary errands. My MIL had to work a trip a few days after the birth, but is coming back again today and staying through the end of the week. 

I'll leave with some more pictures of our little doll.

 Solomon reading to her out of a "book" that he wrote


 This is what happens with older siblings in the house - baby might end up being pushed in a play shopping cart on a pretend grocery store trip. No worries, Solomon was very careful not to let her fall out. 

 Only set her in the bouncer to take her picture

 She really enjoyed this bath. It was so cute.

 That's me, giving her a bath in the kitchen sink.

 With big brother John

 sisters

Miriam is all over the baby, asking to hold her constantly. Becky - not so much :)

Wednesday, December 8, 2010

Announcing...

It's a ........





GIRL!

Anna Marie Anderson was born at home this morning, on her exact due date, at 6:16 am, weighing 6 lbs 13 ozs. Mother and baby are well.

My labor was short, but intense. The midwife and her assistant arrived at our house shortly after 3 am. I will write a more detailed birth story soon.

Thank you to all who prayed!